化痰祛浊方治疗脾虚痰浊阻遏型颈动脉粥样硬化斑块的临床观察

摘要

目的 观察化痰祛浊方治疗脾虚痰浊阻遏型颈动脉粥样硬化斑块的临床疗效.方法 将194例脾虚痰浊阻遏型颈颈动脉粥样硬化斑块患者随机分为2组.对照组97例予辛伐他汀片口服治疗;治疗组97例在对照组治疗基础上予化痰祛浊方治疗.2组疗程均为24周.比较2组治疗前后血清白细胞介素1(IL-1)、肿瘤坏死因子α(TNF-α)、丙二醛(MDA)、超氧化物歧化酶(SOD)、颈动脉内中膜厚度(IMT)、斑块数量、易损斑块数量、斑块面积及血脂指标[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDLC)及高密度脂蛋白胆固醇(HDL-C)],统计2组治疗过程中不良反应发生率.结果 治疗后2组TC、TG、LDL-C均降低(P ＜0.05),HDL-C均升高(P ＜0.05),且治疗组TC、TG、LDL-C低于对照组(P ＜0.05),HDL-C高于对照组(P ＜0.05).治疗后2组IMT、斑块数量、易损斑块数量、斑块面积均降低(P ＜0.05),且治疗组均低于对照组(P ＜0.05).治疗后2组IL-1、TNF-α均降低(P ＜0.05),且治疗组IL-1、TNF-α均低于对照组(P ＜0.05).治疗后2组MDA均降低(P ＜0.05),SOD均升高(P ＜0.05);且治疗组MDA低于对照组(P ＜0.05),SOD高于对照组(P ＜0.05).2组不良反应发生率比较差异无统计学意义(P＞ 0.05).结论化痰祛浊方治疗脾虚痰浊阻遏型颈动脉粥样硬化斑块可改善患者动脉粥样硬化斑块程度,增强调脂功能、降低炎性反应程度和氧化应激程度可能是其重要作用机制.%Objective To observe the clinical effects of Huatan Quzhuo prescription on carotid atherosclerosis plaque with spleen deficiency and phlegm turbidity repression type. Methods 194 patients with carotid atherosclerosis were randomly divided into two groups. 97 cases in control group were treated by simvastatin tablets orally.97 cases in treatment group were treated by Huatan Quzhuo prescription on the basis of the control group. Both groups treated for 24 weeks. The serum interleukin-1 (IL-1), tumor necrosis factor-α (TNF-α), malondialdehyde (MDA), superoxide dismutase (SOD), carotid intima-media thickness (IMT), plaque number, vulnerable plaque number, plaque area and lipid index [ total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) ]were compared before and after treatment in the two groups, and the incidence of adverse reactions during treatment was counted. Results After treatment, TC, TG and LDL-C in two groups were decreased (P ＜ 0. 05), HDL-C was increased (P ＜ 0. 05), and TC, TG and LDL-C in the treatment group were lower than those in the control group (P ＜ 0. 05), HDL-C was higher than that in the control group (P ＜ 0. 05). After treatment, IMT, plaque number, vulnerable plaque number and plaque area in two groups were decreased (P ＜ 0. 05), and the treatment group was lower than the control group (P ＜ 0. 05). After treatment, IL-1 and TNF-α were decreased in both groups (P ＜ 0. 05), and the treatment group was lower than the control group (P ＜ 0. 05). After treatment, MDA was decreased in two groups (P ＜ 0. 05), SOD was increased (P ＜ 0. 05), and MDA in treatment group was lower than that in control group (P ＜ 0. 05), SOD was higher than that in control group (P ＜ 0. 05). There was no significant difference in adverse reactions between the two groups (P＞ 0. 05). Conclusion Huatan Quzhuo prescription can improve the degree of carotid atherosclerosis. Its important mechanism may be to enhance lipid-regulating function, reduce the degree of inflammatory reaction and oxidative stress, which is worthy of clinical application.